超激光照射左侧星状神经节对初发心房纤颤转复预后的影响

Influence of Super Laser Irradiation on the Left Side of the Stellate Ganglion of Incipient Atrial Fibrillation on Converting Prognosis

目的探讨初发心房纤颤转复后1周内联合应用超激光照射左侧星状神经节治疗对患者预后的影响。方法选择2005—2009年我院门诊及住院收治的初发心房纤颤并且及时转复为窦性心律的患者60例,随机分为对照组(n=30)和治疗组(n=30)。对照组应用常规疗法,治疗组在常规疗法基础上加用超激光照射左侧星状神经节治疗10 min,疗程7 d;对比两组复律前及复律7 d、复律1个月及复律1年的收缩压和舒张压、C反应蛋白(CRP)、左房内径(LAD)、左室射血分数(LVEF)及两组复律3年内心房纤颤再发率、脑卒中发生率、心力衰竭发生率和病死率的差异。结果两组复律前后各时间点的血压、CRP、LAD及LVEF比较,差异均有统计学意义(P<0.05),其中,复律7 d时治疗组收缩压和舒张压均明显低于对照组,CRP水平明显低于对照组,差异均有统计学意义(P<0.05)。复律后1个月和复律后1年两组患者LAD和LVEF间差异有统计学意义(P<0.05)。转复后3年内治疗组再发心房纤颤、脑卒中及心力衰竭的发生率均明显少于对照组,差异有统计学意义(P<0.05)。结论初发心房纤颤转复7 d内联合应用超激光照射左侧星状神经节治疗能有效防止初发心房纤颤转复后的再发,并为防止预后不良事件(脑卒中及心力衰竭)的发生起到积极的作用,总体治疗效果及预后良好。

Objective To investigate the influence of super laser irradiation on the left side of the stellate ganglion ofincipient atrial fibrillation on converting prognosis. Methods 60 outpatients and inpatients with incipient atrial fibrillation whichconverted to sinus rhythm admitted to our hospital from 2005 to 2009 were randomly divided into control group （ 30 cases） andtreatment group （30 cases） . The control group was given routine treatment, and the treatment group was given additional superlaser irradiation on the left side of the stellate ganglion for 7 days with each lOmin. The systolic and diastolic blood pressures,CRP,LAD and LVEF of the two groups were compared 7 days before and after sinus rhythm,one month after sinus rhythm andone year after sinus rhythm. The recurrence and mortality of atrial fibrillation,incidence of stroke and heart failure of the twogroups were compared within three years after sinus rhythm. Results The blood pressures,CRP,LAD and LVEF of the twogroups at each time showed statistically significant differences （ P 〈 0. 05 ） . The systolic and diastolic blood pressures of the treat-ment group 7 days after sinus rhythm were significantly lower than the control group,so did the CRP level （ P 〈 0. 05 ） . The LADand LVEF one month after sinus rhythm and one year after sinus rhythm both showed statistically significant differences betweenthe two groups （ P 〈 0. 05 ） . Within three years,the recurrence of atrial fibrillation,stroke and heart failure in treatment groupwas significantly lower than the control group （ P 〈 0. 05 ） . Conclusion Combined use of super laser irradiation on the left sideof the stellate ganglion within 7 days of incipient atrial fibrillation converting is conducive to the prevention of atrial fibrillation recurrence ,as well as to the prevention of adverse events.